Echocardiographic findings in patients with acute coronary syndrome and normal angiogram.
Coronary angiograms performed at the time of an acute coronary syndrome typically present vessel occlusions, ruptured plaques or thrombotic lesions that require reperfusion therapy. However, occasionally, no coronary artery stenoses are detected. Myocardial ischemia frequently causes left ventricular wall motion abnormalities that can be seen easily by echocardiography. In our study we aimed to analyze echocardiographic findings in patients with acute coronary syndrome and normal angiogram. After standardized risk stratification, a total of 897 patients were classified as an acute coronary syndrome and underwent a coronary angiography immediately. In 76/897 patients angiography excluded coronary macroangiopathy. Routine echocardiographic assessment in patients with normal angiogram showed in 21.1% a reduced left ventricular systolic function and 32.9% presented with segmental wall motion abnormalities. In summary, by detection of segmental wall motion abnormalities in 1/3 of patients with suspected acute coronary syndrome and normal angiogram, obviously, an echocardiographic evaluation in this patient population is of clinical relevance. Recommendations for performing echocardiography in patients with suspected acute coronary syndromes independent of angiographic findings are strongly supported. Further analyses should implement echocardiographic techniques as contrast and tissue doppler imaging.
Germing
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A
Medical Clinic II, Cardiology and Angiology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany. alfried.germing@rub.de
Ulrich
S
S
Fadgyas
T
T
Grewe
P
P
Mügge
A
A
Lindstaedt
M
M
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000473:pathology*; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D017202:Myocardial Ischemia / Q000473:pathology; D011379:Prognosis